Article Text

other Versions

PDF
Predictive factors for short term visual outcome after intravitreal triamcinolone acetonide injection for diabetic macular edema: an OCT study
  1. Oswaldo Ferreira Moura Brasil (dico{at}unisys.com.br),
  2. Scott D Smith (smiths{at}ccf.org),
  3. Anat Galor (anatgalor{at}yahoo.com),
  4. Careen Y Lowder (lowderc{at}ccf.org),
  5. Jonathan E Sears (searsj{at}ccf.org),
  6. Peter K Kaiser (pkkaiser{at}aol.com)
  1. Federal University of São Paulo, Brazil
  2. Cole Eye Institute, Cleveland Clinic, United States
  3. Cole Eye Institute, Cleveland Clinic, United States
  4. Cole Eye Institute, Cleveland Clinic, United States
  5. Cole Eye Institute, Cleveland Clinic, United States
  6. Cole Eye Institute, Cleveland Clinic, United States

    Abstract

    Aim: To evaluate the predictive factors for visual outcome after intravitreal triamcinolone acetonide injection to treat refractory diabetic macular edema.

    Methods: We performed a retrospective chart review of patients with diabetic macular edema who met the following inclusion criteria: clinically significant diabetic macular edema, receipt of a 4mg/0.1ml intravitreal triamcinolone acetonide injection, and optical coherence tomography (OCT) of the macula performed up to ten days prior to injection. All patients received a full ophthalmic examination including best-corrected Snellen visual acuity (VA). The main outcome measure was the mean change in vision 3 months after injection.

    Results: Data from 73 eyes of 59 patients were analyzed. After a mean follow-up of 324 days, the mean change in vision was -0.075 logMAR units with 27.3% improving ? 3 lines, 6.8% declining ? 3 lines and 60.2% remaining stable within 1 line of baseline vision. Statistical analysis was performed using multivariate generalized estimating equations based on data from 52 eyes of 42 patients. Factors associated with an improvement in vision 3 months after injection were worse baseline visual acuity (-0.27 logMAR units/unit increase in baseline VA, P=0.002) and presence of subretinal fluid (-0.17 logMAR units, P=0.06). The presence of cystoid macular edema negatively affected the visual outcome (0.15 logMAR units, P=0.03). In addition, the presence of an epiretinal membrane (ERM) was associated with less visual improvement. ERM modified the effect of baseline VA as demonstrated by a significant interaction between these two variables (0.34 logMAR units/unit increase in baseline VA, P=0.04).

    Conclusions: OCT factors and baseline visual acuity can be useful in predicting visual acuity outcomes 3 months after intravitreal triamcinolone acetonide injection in patients with refractory diabetic macular edema.

    • Diabetes Mellitus
    • Diabetic Retinopathy
    • Epiretinal Membrane
    • Macular Edema
    • Triamcinolone Acetonide

    Statistics from Altmetric.com

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.